Some New Findings in the Pathogenesis of Myeloproliferative Disorders and New Insight into More Effective Treatment
Některé nové poznatky o patogenezi myeloproliferativních onemocnění a možnosti jejich efektivnější léčby
Pokroky molekulární biologie umožnily hlubší porozumění patgeneze myeloproliferativních onemocnění, na které dnes pohlížíme jako na poruchu hematopoetické kmenové buňky. Je podán stručný přehled genetických poruch, které vedou ke vzniku chronické myeloidní leukémie, myelodysplastického syndromu a akutní myeloidní leukémie. Ve druhé části sdělení jsou probrány různé způsoby molekulárně cílené léčby, které byly vyvinuty na základě nových poznatků. Jde především o způsoby ovlivňující zvýšenou proliferaci, jako jsou inhibitory tyrozikináz (imatinib, dasatinib), inhibitory farnesyltransferázy (tipifarnib), inhibitory angiogeneze (bevacizumab) a dále induktory diferenciace (hypometylační látky) a induktory apoptózy. Podrobnější informace je věnována látkám, které se již prověřují v rámci klinických studií.
Klíčová slova:
leukemická krvetvorba, myeloproliferativní onemocnění, nové léčebné způsoby.
Authors:
P. Klener
Authors‘ workplace:
1. interní klinika 1. LF UK a VFN a ÚHKT, Praha
Published in:
Čas. Lék. čes. 2006; 145: 4-8
Category:
Editorial
Overview
Advances in molecular biology and genomics enabled more detailed view on the pathogenesis of myeloproliferative disorders, which are considered to be a diseases of hematopoietic stem cell. The autor provides an brief overview of the genetic alterations, leading to the chronic myeloid leukemia, myelodysplastic syndrome and acute myeloid leukemia. In the second part, molecular targeted therapies that have been developed based on these insights are reviewed. These are particularly methods preventing increased proliferation such as inhibition of tyrosinkinases (imatinib, dasatinib), inhibitions of farnesyltransferase (tipifarnib), inhibition of angiogenesis (bevacizumab, vatalanib), induction of diferentiation (hypomethylating agenents) and induction of apoptosis (bortezomib). More detailed information is given on some novel drugs which are currently in clinical trials.
Key words:
leukemic hematopoiesis, myeloproliferative disorders, novel therapies.
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